Remote Control Diabetes? Not

Maybe I’m just too cynical (surprise, surprise), but I’m having a hard time swallowing the buzz about all the new wireless monitoring devices for diabetes. And I’m NOT talking about continuous glucose monitors (CGMS) this time, but rather the rash of new products that will transmit your blood glucoseRemote_control_gal results to your doctor, nurse or educator via wireless computer technology.

Renowned patient-expert David Mendosa gives a great overview in a recent blog post. He introduces all the contenders:

* GlucoTel — which will use Bluetooth technology to connect almost any cell phone to transmit your blood glucose data (currently awaiting FDA approval)

* Virtual Tracker — which I reviewed here recently. A complete system including a glucose meter (GlucoLab brand) and a “cradle” port for loading the stored readings and sending them over the Internet to a proprietary database (FDA status unclear).

* Diabetech’s GlucoMON — which will automatically send BG test results levels downloaded from the OneTouch Ultra meter to a cradle and includes its own two-way nationwide wireless network instead of using your cell phone (patient studies recruiting Right Now!)

* GlucoPack Phone from HealthPia America — which the company says is the world’s first all-in-one blood glucose meter and cell phone and service for managing diabetes remotely (reportedly received FDA approval in June).

* MedApps D-PAL system – which is under development.  Another BG monitoring device that will transmit results via cell phone to a server. (Initially targetted at Medicare and Medicaid patients.)

They all sound very powerful and space-age. But the question that still remains for me is:

WHAT IS GOING TO HAPPEN TO ALL THIS TRANSMITTED BG DATA?

Which providers will have the time, training, or motivation to sort through it all?

One effort is DiabetesHouseCall.com (DHC), which promises a “concierge-style relationship with your endocrinologist.” Which sounds suspicously too good to be true.  But I’m hoping…

Otherwise, I’d have to agree with commenter Vicki A. that these systems seem to all point to one thing: us patients being more dependent than ever on our “healthcare team” to tell us what to do. I’m also putting my money on “the more efficient system being CGMS,” which patients wear and can use to make their own decisions/necessary BG management changes immediately.

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9 Responses

  1. Sarah
    Sarah October 18, 2006 at 7:25 am | | Reply

    Amy,
    I’ve always believed that to have the best control possible of your diabetes you need to be able to make good decisions independent of your doctor concerning managing your sugar levels and insulin. Point being, if my blood sugar is 350, do I call my doctor and ask if it is alright to adjust my normal insulin dosage, or do I just go ahead and figure out on my own that it is probably going to be okay to correct for this high? That is to one extreme, but in my experience with diabetics, I’ve actually met diabetics that were so dependent on their health care team that they would choose to not correct their high. A prescribed dosage is a prescribed dosage right? I love my endocrine team for the insight they give me into my sugars, and their willingness to make changes that I can’t see need to be made or resist making for whatever reason. I need to be able to manage my sugars greatly on my own though. I only see them every three months!

  2. Chrissie in Belgium
    Chrissie in Belgium October 18, 2006 at 7:34 am | | Reply

    Yup I am quite sceptical to the wireless info feed to doctors. I really do doubt they have the time or organization to handle it. CGMs seem to be a better way to go – although they do demand dedication from the patient and still remain very expensive.

  3. ralph berry
    ralph berry October 18, 2006 at 7:43 am | | Reply

    My Dad was a phsician and he used to say let the doctor in you heal yourself. I have lived by that motto pretty much for almost 60 years of type one diabetes and can not agree more with the better done by the one who knows it best which is the patient.

  4. Scott K. Johnson
    Scott K. Johnson October 18, 2006 at 8:20 am | | Reply

    And really what use are the numbers if they don’t have the surrounding circumstances (the “complete picture”).

    I also would like to say I’m a big fan of David Mendosa. He has been a great resource for the diabetes community for a very long time.

  5. Becky
    Becky October 18, 2006 at 9:32 am | | Reply

    I agree that I wouldn’t use this technology to communicate with Drs. but this could be very helpful for parents of youngsters with diabetes. Putting your child in others care is difficult and having bs sent to us could solve alot of problems with schools/daycares. We are very lucky to have a great school, but there are some horror stories out there.

    Of course, now that I have my son on the Dexcom, I wouldn’t be happy with finger poke values alone LOL!! I would want to know direction and rate of change! Now they need to work on wirelessly sending data from CGMS to our cell phones :)

  6. Scott
    Scott October 18, 2006 at 9:50 am | | Reply

    Although I like the idea of combining my cell phone with my meter using something like the GlucoPack Phone from HealthPia America, I do not care for the idea of sending the data to a centralized database of any type, let alone to my doctor. That sounds like another way of introducing identity theft to me.

  7. Alice H
    Alice H October 18, 2006 at 10:07 am | | Reply

    (One of my jobs is validating medical software, although I’ve never done any software for diabetes monitoring.)

    I think a lot of it will depend on how the data is output at the doctor’s end. If the software designers are smart, they’ve put alerts into the output to let the doctors eyeball a report in a short time to see if there’s a problem – i.e. printing worrisome results in a different color, or including a warning message in the report header. (This is what is done for studies where a device is used to monitor respiratory data collected with a diary device.)

    Probably the only way it’s going to be useful is for trending and to let the doctor know if a patient is being non-compliant with their insulin dosage. But if someone’s being non-compliant, why would they use a device that’s going to alert their doctor?

  8. Kevin McMahon
    Kevin McMahon October 19, 2006 at 2:38 pm | | Reply

    Hi Amy,

    You probably are being too cynical ;)

    - most often the data is used directly by the patient for self-management in the form of automatic reports, reminders, and alerts (patient’s always manage themselves).

    - wireless glucose meter data never goes directly to anyone. It’s managed by complex informatics algorithms that consider the patient profile, real-time disease state, and any one of a number of Intensive Management Protocols that may be applicable at the moment (ie – Islet Cell Transplant patient surveillance, Newly Diagnosed Type 1, Type 2 pharma transition from oral meds to MDI, etc…).

    - Diabetes House Call is paid out of pocket via the patient’s Health Savings Account, Flexible Spending Account or MC/VISA/AMEX. The Pilot for this new model of premium care is targeting those who demand more and is being conducted in partnership with Driscoll Children’s Hospital. DHC endos get to work with a lighter patient load and deliver the level of care that most endos wish they could offer but can’t due to the current insurance-centric model.

    If you really want to understand how patient’s are getting better results, read for yourself at:

    http://www.diabetech.net/sharedExperiences.html

    This is a new area and Diabetech is making exciting progress improving patient outcomes every day with wireless technology.

  9. JIM MAIRS
    JIM MAIRS October 31, 2006 at 6:47 pm | | Reply

    I am a type I who has been unable to get Lifescans OneTouch software v2.3 to communicate with its own data base initially or its Customerservice to communicate with me even after being switched to level 2 service and assigned a manager (Sabrina) to”personally oversee” my problem. I believe such rude treatment given under the name of customer service needs to be exposed. How does one best go about this?

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